Image marker-based navigation using a tracking frame

ABSTRACT

Disclosed is a computer-implemented method for navigating an anatomical body part, a corresponding computer program, a non-transitory program storage medium storing such a program and a computer for executing the program, as well as a system for navigating the anatomical body part, the system comprising an electronic data storage device and the aforementioned computer, and to a system for conducting medical navigation.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. Application Ser. No.16/316,447, filed Jan. 9, 2019, which was the National Stage ofInternational Application No. PCT/EP2017/069454, filed Aug. 1, 2017.

The present invention relates to a computer-implemented method fornavigating an anatomical body part, a corresponding computer program, anon-transitory program storage medium storing such a program and acomputer for executing the program, as well as a system for navigatingthe anatomical body part, the system comprising an electronic datastorage device and the aforementioned computer, and to a system forconducting medical navigation.

TECHNICAL BACKGROUND

Automatic image registration is a straight-forward method to directlycorrelate image data with patient space in a navigated intraoperativeimaging workflow. Therefore, either a registration frame is needed whichincludes image markers visible in image data.

There are currently two approaches of how the step of automaticregistration can be performed:

First approach: The registration frame 4 has by construction a knownrelation to the tracking frame 13 (as shown in FIG. 1a ). The trackingframe 13 is fixed to the registration frame 4 and there is noflexibility in positioning the tracking frame 4.

Second approach: An additional tracking frame 13 a with a known relationto the registration frame 4 is used (see FIG. 1b ). The tracking frame13 can be positioned variably as the additional tracking frame 13 a isfixed to the registration frame 4. However, an extra transformation stepbetween the additional tracking frame 13 a and the actual tracking frame13 has to be done.

If the registration frame has by construction a known relation to thetracking frame, the operation room setup and patient positioning is verylimited. If an additional tracking frame is used, the registrationaccuracy suffers due to an extra coordinate transformation step that isneeded. In addition there are setup problems such as visibility of thetracking frames.

Pre-calibrated methods suffer from the need to perform and maintaincalibrations that can deteriorate by time. This depends on the hardwareof the used scanner and the need to put a permanent tracking frame onthe scanner. Maintenance of the scanner, e.g. removing covers where thetracking frame is mounted, or wear of the covers requirere-calibrations.

The present invention is designed to provide an improved method forautomatic image registration.

The present invention can be used in connection with navigationapplications produced by Brainlab AG.

Aspects of the present invention, examples and exemplary steps and theirembodiments are disclosed in the following. Different exemplary featuresof the invention can be combined in accordance with the inventionwherever technically expedient and feasible.

EXEMPLARY SHORT DESCRIPTION OF THE PRESENT INVENTION

In the following, a short description of the specific features of thepresent invention is given which shall not be understood to limit theinvention only to the features or a combination of the featuresdescribed in this section.

The disclosed method encompasses imaging a patient's anatomical bodypart, a registration frame containing image markers and a tracking framecontaining at least one image marker which is attached to theregistration frame. The thus obtained image showing all threeaforementioned entities allows determining the spatial relationshipbetween the anatomical body part, the registration frame and thetracking frame. The tracking frame additionally comprises opticalmarkers for navigating a medical procedure, and a registration betweenthe optical markers and the anatomical body part is established on thebasis of the aforementioned spatial relationship in conjunction withconstruction data of the tracking frame containing information about thespatial relationship between the optical markers and the at least oneimage marker contained in the tracking frame. A system comprising theregistration frame and the tracking frame is also disclosed.

GENERAL DESCRIPTION OF THE PRESENT INVENTION

In this section, a description of the general features of the presentinvention is given for example by referring to possible embodiments ofthe invention.

In general, the invention reaches the aforementioned object byproviding, in a first aspect, a computer-implemented medical dataprocessing method for navigating an anatomical body part. The methodcomprises executing, on at least one processor of at least one computer(for example at least one computer being part of the navigation system),the following exemplary steps which are executed by the at least oneprocessor.

In a (for example first) exemplary step, planning image data is acquiredwhich depicts (i.e. defines an image, for example a planning image, of)an anatomical body part (such as at least part of the head or of anextremity) supported by a patient support device (such as a head rest ora support device for an extremity) and at least three image markersprovided in or on a registration frame attached to the patient supportdevice. The planning image data describes a frame-patient-transformationdefining a relative position between the at least three image markers onthe one hand and the anatomical body part on the other hand. The imagemarkers are arranged in or on the registration frame for example in apredetermined (e.g. at least one of known or fixed) unsymmetric pattern,for example three-dimensionally unsymmetric three-dimensional pattern,to allow determination of the orientation of the registration frame inthe planning image. The planning image data further describes atracking-registration-transformation defining a relative positionbetween an (for example, at least one, for example exactly one, in afurther example at least or exactly three) image marker provided in oron a tracking frame which is directly or indirectly (e.g. via a furtherunit or device, such as a connector) connected to the registration frameon the one hand and the image markers provided in or on the registrationframe on the other hand.

Within the meaning of this disclosure, a transformation is understood tobe for example a mapping such as a linear transformation betweenpositions and/or coordinate systems which can be expressed for exampleas a matrix multiplication.

The planning image data is for example two- or three-dimensional imagedata (for example, it is tomographic image data). For example, theplanning image data has been generated by applying a computed x-raytomography or magnetic resonance tomography imaging modality to theanatomical body part and the patient support device and the registrationframe and the tracking frame, for example by applying the respectiveimaging modality to the anatomical body part and the patient supportdevice and the registration frame in a state in which it is attached tothe patient support device and the tracking frame in a state in which itis connected to the registration frame simultaneously so that theplanning image data depicts the anatomical body part and the imagemarkers of the registration frame. It is not necessary that the planningimage data depicts the patient support device, which also is generallynot the case because the patient support device is normally designed tobe at least substantially transparent for the relevant imagingmodalities.

The image markers are for example radio-opaque structures (such asspheres containing a material at least partly made from at least one ofthe substances contained in the group consisting of barium, bismuth,tungsten, gold, titanium, iridium, platinum or rhenium, or for examplemade from a polymer in combination with one of the aforementionedsubstances, or at least partly made of a ceramic) ornuclear-magnetically resonant structure (such as fat-water filledspheres) embedded in a comparably less radio-opaque part of the trackingframe and the registration frame, respectively.

The tracking frame is an embodiment of a marker device, for example itis a reference star bearing at least three (for example, exactly threeor exactly four) optical markers, and the aforementioned at least oneimage marker. The tracking frame furthermore comprises a plurality of(for example, at least three, for example exactly three, or at leastfour, for example exactly four) optical markers in a predetermined (e.g.at least one of known or fixed) spatial relationship (e.g. at least oneof position and orientation) relative to the at least one image markerprovided in or on the tracking frame.

In one example, the tracking frame includes a tracking marker arrayincluding the at least three optical markers and a tracking frameconnector which is connected to both the tracking marker array and theregistration frame. The image marker provided in or on the trackingframe may be provided for example in or on the tracking frame connector.In one variation of this example, the tracking marker array and thetracking frame connector are provided as a single piece (i.e. in onepiece) or as separate connectable and/or connected pieces.

In one example, the tracking frame is attached to the registration frameat a predetermined position on the registration frame (for example, oneof a plurality of, e.g. exactly four, fixed positions on theregistration frame for attaching the tracking frame to the registrationframe). For example, the registration frame is provided with a pluralityof such as at least two [for example, exactly four] attachment parts forattaching the tracking frame (for example in a predetermined orientationrelative to the registration frame) or, as far as the method includesusing the tracking frame connector, the tracking frame connector (forexample in a predetermined orientation relative to the registrationframe). For example, the location of the predetermined position isdetermined (as part of the method according to the first aspect) basedon the tracking-registration-transformation and the relative positionbetween the image markers provided in or on the registration frame isdetermined based on the location of the predetermined position and theconstruction data, for example based on the tracking frametransformation.

In one example of the disclosed method, the image markers are or havebeen imaged using a first imaging modality (for example, athree-dimensional imaging modality such as a tomographic imagingmodality such as computed x-ray tomography or magnetic resonancetomography or a sonography or a two-dimensional imaging modality such asfluoroscopy). For example, the optical markers are or have been detectedusing a navigation modality (such as infrared or electromagnetictracking), wherein the navigation modality operates in anelectromagnetic wavelength band different, for example disjunct, fromthe wavelength band in which the imaging modality operates.

In a (for example second) exemplary step, construction data (availablefor example from computer-aided design of the tracking frame) isacquired which describes a predetermined tracking frame-transformationdefining a relative position between at least three optical markers andthe image marker provided in or on the tracking frame.

In a (for example third) exemplary step, a registration of theanatomical body part is determined as a relative position between theoptical markers and the depiction of the anatomical body part by theplanning image data. The registration is determined based on theframe-patient-transformation and by determining the relative positionbetween the image markers provided in or on the registration frame onthe one hand and the optical markers on the other hand based on thetracking-registration-transformation and the trackingframe-transformation. The registration constitutes for example adefinition of a spatial relationship between the optical markers and thedepiction of the anatomical body part (the position of the anatomicalpart being defined in the coordinate space of the planning image data,i.e. a planning reference system), and being related to the position ofthe optical markers which is defined in the coordinate space in whichnavigation is conducted (i.e. a navigation reference system) via atransformation defined by e.g. the frame-patient transformation and thetracking-registration-transformation and the trackingframe-transformation. That spatial relationship may be stored forfurther use during e.g. a navigated medical procedure.

In one example, the frame-patient-transformation is defined in theplanning reference system. In that case, for example, marker navigationdata is acquired which describes a position of the optical markers inthe navigation reference system, and the position of the anatomical bodypart is transformed between a planning reference system in whichpositions in the planning image data are defined and the navigationreference system using a reference system transformation (i.e. atransformation between the reference systems, namely between thenavigation reference system and the planning reference system). Forexample, the position of the anatomical body part is transformed fromthe planning reference system into the navigation reference system usingthe reference system transformation.

In a second aspect, the invention is directed to a computer programwhich, when running on at least one processor (for example, a processor)of at least one computer (for example, a computer) or when loaded intoat least one memory (for example, a memory) of at least one computer(for example, a computer), causes the at least one computer to performthe above-described method according to the first aspect. The inventionmay alternatively or additionally relate to a (physical, for exampleelectrical, for example technically generated) signal wave, for examplea digital signal wave, carrying information which represents theprogram, for example the aforementioned program, which for examplecomprises code means which are adapted to perform any or all of thesteps of the method according to the first aspect.

In a third aspect, the invention is directed to a non-transitorycomputer-readable program storage medium on which the program accordingto the fourth aspect is stored.

In a fourth aspect, the invention is directed to at least one computer(for example, a computer), comprising at least one processor (forexample, a processor) and at least one memory (for example, a memory),wherein the program according to the fourth aspect is running on theprocessor or is loaded into the memory, or wherein the at least onecomputer comprises the computer-readable program storage mediumaccording to the fifth aspect.

In a fifth aspect, the invention is directed to a system for conductingmedical navigation, the system according to the fifth aspect comprising:

-   -   a) a tracking frame (such as the above-described tracking frame)        including at least one image marker and at least three optical        markers, for example including a tracking marker array        comprising the three optical markers; and    -   b) a registration frame (such as the above-described        registration frame), comprising:        -   a patient support unit attachment portion for attaching the            registration frame to a patient support unit (such as a the            above-described patient support unit);        -   at least three image markers which are arranged, for example            in a three-dimensional unsymmetric pattern, in or on the            registration frame; and        -   at least one (for example, a plurality of, e.g. four or            exactly four) attachment part for attaching the tracking            frame directly (i.e. without any separate intermediate part)            or indirectly (i.e. via a tracking frame connector) to the            registration frame.

The system according to the fifth aspect is suitable for use withinexecution of the method according to the first aspect.

In one example of the system according to the fifth aspect, the trackingframe comprises a tracking marker array comprising the three opticalmarkers and a tracking frame connector for connecting the trackingmarker array with the registration frame, wherein the at least one imagemarker provided in or on the tracking frame is provided in or on thetracking frame connector. In one variation of this example, the trackingmarker array and the tracking frame connector are provided as a singlepiece (i.e. in one piece) or as separate connectable and/or connectedpieces. Having the two parts as separate pieces provides the advantagethat only the tracking frame connector needs to be imaged for generationof the planning image data and that the tracking marker array does notneed to be attached to the registration frame during the imagingprocedure because the tracking marker array may be damaged or otherwisehamper the imaging procedure.

In one example of the system according to the fifth aspect, theattachment part is constituted such that the tracking frame isattachable to the registration frame in a predetermined orientationrelative to the registration frame.

In one example of the system according to the fifth aspect, at least two(for example, exactly two, three or exactly three) image markers areprovided in or on the tracking frame (if applicable, for example in oron the tracking frame connector), and wherein the attachment part isconstituted such that the tracking frame is attachable to theregistration frame in a not-predetermined orientation relative to theregistration frame.

In a sixth aspect, the invention is directed to a system for navigatingan anatomical body part, the system according to the sixth aspectcomprising:

-   -   a) the at least one computer according to the fourth aspect;    -   b) at least one electronic data storage device storing at least        the planning image data and the construction data; and    -   c) the system according to the fifth aspect; and    -   d) a tracking device (for example, a stereoscopic camera        operating in the infrared wavelength band) for tracking the        position of the optical markers,    -   wherein the at least one computer is operably coupled to        -   the at least one electronic data storage device for            acquiring, from the at least one data storage device, at            least the planning image data and the construction data, and        -   to the tracking device for acquiring, from the tracking            device, signals corresponding to information about the            positions of the optical markers.

In general, the invention does not involve or for example comprise orencompass an invasive step which would represent a substantial physicalinterference with the body requiring professional medical expertise tobe carried out and entailing a substantial health risk even when carriedout with the required professional care and expertise. For example, theinvention does not comprise a step of irradiating the anatomical bodypart and/or the patient's body with ionizing radiation so that it doesnot comprise any steps of therapy of the human or animal body, forexample it does not comprise any step of radiotherapy or radiosurgery.More particularly, the invention does not involve or in particularcomprise or encompass any surgical or therapeutic activity. Theinvention is instead directed as applicable to registering a patientplaced ready for a medical procedure to a planning image for examplebefore any therapeutic or surgical activity ensues. For this reasonalone, no surgical or therapeutic activity and in particular no surgicalor therapeutic step is necessitated or implied by carrying out theinvention.

It is within the scope of the present invention to combine one or morefeatures of one or more embodiments or aspects of the invention in orderto form a new embodiment wherever this is technically expedient and/orfeasible. Specifically, a feature of one embodiment which has the sameor a similar function to another feature of another embodiment can beexchanged with said other feature, and a feature of one embodiment whichadds an additional function to another embodiment can for example beadded to said other embodiment.

DEFINITIONS

In this section, definitions for specific terminology used in thisdisclosure are offered which also form part of the present disclosure.

The method in accordance with the invention is for example a computerimplemented method. For example, all the steps or merely some of thesteps (i.e. less than the total number of steps) of the method inaccordance with the invention can be executed by a computer (forexample, at least one computer). An embodiment of the computerimplemented method is a use of the computer for performing a dataprocessing method. An embodiment of the computer implemented method is amethod concerning the operation of the computer such that the computeris operated to perform one, more or all steps of the method.

The computer for example comprises at least one processor and forexample at least one memory in order to (technically) process the data,for example electronically and/or optically. The processor being forexample made of a substance or composition which is a semiconductor, forexample at least partly n- and/or p-doped semiconductor, for example atleast one of II-, III-, IV-, V-, VI-semiconductor material, for example(doped) silicon and/or gallium arsenide. The calculating steps describedare for example performed by a computer. Determining steps orcalculating steps are for example steps of determining data within theframework of the technical method, for example within the framework of aprogram. A computer is for example any kind of data processing device,for example electronic data processing device. A computer can be adevice which is generally thought of as such, for example desktop PCs,notebooks, netbooks, etc., but can also be any programmable apparatus,such as for example a mobile phone or an embedded processor. A computercan for example comprise a system (network) of “sub-computers”, whereineach sub-computer represents a computer in its own right. The term“computer” includes a cloud computer, for example a cloud server. Theterm “cloud computer” includes a cloud computer system which for examplecomprises a system of at least one cloud computer and for example aplurality of operatively interconnected cloud computers such as a serverfarm. Such a cloud computer is preferably connected to a wide areanetwork such as the world wide web (WWW) and located in a so-calledcloud of computers which are all connected to the world wide web. Suchan infrastructure is used for “cloud computing”, which describescomputation, software, data access and storage services which do notrequire the end user to know the physical location and/or configurationof the computer delivering a specific service. For example, the term“cloud” is used in this respect as a metaphor for the Internet (worldwide web). For example, the cloud provides computing infrastructure as aservice (IaaS). The cloud computer can function as a virtual host for anoperating system and/or data processing application which is used toexecute the method of the invention. The cloud computer is for examplean elastic compute cloud (EC2) as provided by Amazon Web Services™. Acomputer for example comprises interfaces in order to receive or outputdata and/or perform an analogue-to-digital conversion. The data are forexample data which represent physical properties and/or which aregenerated from technical signals. The technical signals are for examplegenerated by means of (technical) detection devices (such as for exampledevices for detecting marker devices) and/or (technical) analyticaldevices (such as for example devices for performing (medical) imagingmethods), wherein the technical signals are for example electrical oroptical signals. The technical signals for example represent the datareceived or outputted by the computer. The computer is preferablyoperatively coupled to a display device which allows informationoutputted by the computer to be displayed, for example to a user. Oneexample of a display device is an augmented reality device (alsoreferred to as augmented reality glasses) which can be used as “goggles”for navigating. A specific example of such augmented reality glasses isGoogle Glass (a trademark of Google, Inc.). An augmented reality devicecan be used both to input information into the computer by userinteraction and to display information outputted by the computer.Another example of a display device would be a standard computer monitorcomprising for example a liquid crystal display operatively coupled tothe computer for receiving display control data from the computer forgenerating signals used to display image information content on thedisplay device. A specific embodiment of such a computer monitor is adigital lightbox. The monitor may also be the monitor of a portable, forexample handheld, device such as a smart phone or personal digitalassistant or digital media player.

Within the framework of the invention, computer program elements can beembodied by hardware and/or software (this includes firmware, residentsoftware, micro-code, etc.). Within the framework of the invention,computer program elements can take the form of a computer programproduct which can be embodied by a computer-usable, for examplecomputer-readable data storage medium comprising computer-usable, forexample computer-readable program instructions, “code” or a “computerprogram” embodied in said data storage medium for use on or inconnection with the instruction-executing system. Such a system can be acomputer; a computer can be a data processing device comprising meansfor executing the computer program elements and/or the program inaccordance with the invention, for example a data processing devicecomprising a digital processor (central processing unit or CPU) whichexecutes the computer program elements, and optionally a volatile memory(for example a random access memory or RAM) for storing data used forand/or produced by executing the computer program elements. Within theframework of the present invention, a computer-usable, for examplecomputer-readable data storage medium can be any data storage mediumwhich can include, store, communicate, propagate or transport theprogram for use on or in connection with the instruction-executingsystem, apparatus or device. The computer-usable, for examplecomputer-readable data storage medium can for example be, but is notlimited to, an electronic, magnetic, optical, electromagnetic, infraredor semiconductor system, apparatus or device or a medium of propagationsuch as for example the Internet. The computer-usable orcomputer-readable data storage medium could even for example be paper oranother suitable medium onto which the program is printed, since theprogram could be electronically captured, for example by opticallyscanning the paper or other suitable medium, and then compiled,interpreted or otherwise processed in a suitable manner. The datastorage medium is preferably a non-volatile data storage medium. Thecomputer program product and any software and/or hardware described hereform the various means for performing the functions of the invention inthe example embodiments. The computer and/or data processing device canfor example include a guidance information device which includes meansfor outputting guidance information. The guidance information can beoutputted, for example to a user, visually by a visual indicating means(for example, a monitor and/or a lamp) and/or acoustically by anacoustic indicating means (for example, a loudspeaker and/or a digitalspeech output device) and/or tactilely by a tactile indicating means(for example, a vibrating element or a vibration element incorporatedinto an instrument). For the purpose of this document, a computer is atechnical computer which for example comprises technical, for exampletangible components, for example mechanical and/or electroniccomponents. Any device mentioned as such in this document is a technicaland for example tangible device.

The expression “acquiring data” for example encompasses (within theframework of a computer implemented method) the scenario in which thedata are determined by the computer implemented method or program.Determining data for example encompasses measuring physical quantitiesand transforming the measured values into data, for example digitaldata, and/or computing (and e.g. outputting) the data by means of acomputer and for example within the framework of the method inaccordance with the invention. The meaning of “acquiring data” also forexample encompasses the scenario in which the data are received orretrieved by (e.g. input to) the computer implemented method or program,for example from another program, a previous method step or a datastorage medium, for example for further processing by the computerimplemented method or program. Generation of the data to be acquired maybut need not be part of the method in accordance with the invention. Theexpression “acquiring data” can therefore also for example mean waitingto receive data and/or receiving the data. The received data can forexample be inputted via an interface. The expression “acquiring data”can also mean that the computer implemented method or program performssteps in order to (actively) receive or retrieve the data from a datasource, for instance a data storage medium (such as for example a ROM,RAM, database, hard drive, etc.), or via the interface (for instance,from another computer or a network). The data acquired by the disclosedmethod or device, respectively, may be acquired from a database locatedin a data storage device which is operably to a computer for datatransfer between the database and the computer, for example from thedatabase to the computer. The computer acquires the data for use as aninput for steps of determining data. The determined data can be outputagain to the same or another database to be stored for later use. Thedatabase or database used for implementing the disclosed method can belocated on network data storage device or a network server (for example,a cloud data storage device or a cloud server) or a local data storagedevice (such as a mass storage device operably connected to at least onecomputer executing the disclosed method). The data can be made “readyfor use” by performing an additional step before the acquiring step. Inaccordance with this additional step, the data are generated in order tobe acquired. The data are for example detected or captured (for exampleby an analytical device). Alternatively or additionally, the data areinputted in accordance with the additional step, for instance viainterfaces. The data generated can for example be inputted (for instanceinto the computer). In accordance with the additional step (whichprecedes the acquiring step), the data can also be provided byperforming the additional step of storing the data in a data storagemedium (such as for example a ROM, RAM, CD and/or hard drive), such thatthey are ready for use within the framework of the method or program inaccordance with the invention. The step of “acquiring data” cantherefore also involve commanding a device to obtain and/or provide thedata to be acquired. In particular, the acquiring step does not involvean invasive step which would represent a substantial physicalinterference with the body, requiring professional medical expertise tobe carried out and entailing a substantial health risk even when carriedout with the required professional care and expertise. In particular,the step of acquiring data, for example determining data, does notinvolve a surgical step and in particular does not involve a step oftreating a human or animal body using surgery or therapy. In order todistinguish the different data used by the present method, the data aredenoted (i.e. referred to) as “XY data” and the like and are defined interms of the information which they describe, which is then preferablyreferred to as “XY information” and the like.

In the field of medicine, imaging methods (also called imagingmodalities and/or medical imaging modalities) are used to generate imagedata (for example, two-dimensional or three-dimensional image data) ofanatomical structures (such as soft tissues, bones, organs, etc.) of thehuman body. The term “medical imaging methods” is understood to mean(advantageously apparatus-based) imaging methods (for example so-calledmedical imaging modalities and/or radiological imaging methods) such asfor instance computed tomography (CT) and cone beam computed tomography(CBCT, such as volumetric CBCT), x-ray tomography, magnetic resonancetomography (MRT or MRI), conventional x-ray, sonography and/orultrasound examinations, and positron emission tomography. For example,the medical imaging methods are performed by the analytical devices.Examples for medical imaging modalities applied by medical imagingmethods are: X-ray radiography, magnetic resonance imaging, medicalultrasonography or ultrasound, endoscopy, elastography, tactile imaging,thermography, medical photography and nuclear medicine functionalimaging techniques as positron emission tomography (PET) andSingle-photon emission computed tomography (SPECT), as mentioned byWikipedia. The image data thus generated is also termed “medical imagingdata”. Analytical devices for example are used to generate the imagedata in apparatus-based imaging methods. The imaging methods are forexample used for medical diagnostics, to analyse the anatomical body inorder to generate images which are described by the image data. Theimaging methods are also for example used to detect pathological changesin the human body. However, some of the changes in the anatomicalstructure, such as the pathological changes in the structures (tissue),may not be detectable and for example may not be visible in the imagesgenerated by the imaging methods. A tumour represents an example of achange in an anatomical structure. If the tumour grows, it may then besaid to represent an expanded anatomical structure. This expandedanatomical structure may not be detectable; for example, only a part ofthe expanded anatomical structure may be detectable. Primary/high-gradebrain tumours are for example usually visible on MRI scans when contrastagents are used to infiltrate the tumour. MRI scans represent an exampleof an imaging method. In the case of MRI scans of such brain tumours,the signal enhancement in the MRI images (due to the contrast agentsinfiltrating the tumour) is considered to represent the solid tumourmass. Thus, the tumour is detectable and for example discernible in theimage generated by the imaging method. In addition to these tumours,referred to as “enhancing” tumours, it is thought that approximately 10%of brain tumours are not discernible on a scan and are for example notvisible to a user looking at the images generated by the imaging method.

A marker device can for example be a reference star or a pointer or asingle marker or a plurality of (individual) markers which are thenpreferably in a predetermined spatial relationship. A marker devicecomprises one, two, three or more markers, wherein two or more suchmarkers are in a predetermined spatial relationship. This predeterminedspatial relationship is for example known to a navigation system and isfor example stored in a computer of the navigation system.

A “reference star” refers to a device with a number of markers,advantageously three markers, attached to it, wherein the markers are(for example detachably) attached to the reference star such that theyare stationary, thus providing a known (and advantageously fixed)position of the markers relative to each other. The position of themarkers relative to each other can be individually different for eachreference star used within the framework of a surgical navigationmethod, in order to enable a surgical navigation system to identify thecorresponding reference star on the basis of the position of its markersrelative to each other. It is therefore also then possible for theobjects (for example, instruments and/or parts of a body) to which thereference star is attached to be identified and/or differentiatedaccordingly. In a surgical navigation method, the reference star servesto attach a plurality of markers to an object (for example, a bone or amedical instrument) in order to be able to detect the position of theobject (i.e. its spatial location and/or alignment). Such a referencestar for example features a way of being attached to the object (forexample, a clamp and/or a thread) and/or a holding element which ensuresa distance between the markers and the object (for example in order toassist the visibility of the markers to a marker detection device)and/or marker holders which are mechanically connected to the holdingelement and which the markers can be attached to.

In another embodiment, a marker device comprises an optical pattern, forexample on a two-dimensional surface. The optical pattern might comprisea plurality of geometric shapes like circles, rectangles and/ortriangles. The optical pattern can be identified in an image captured bya camera, and the position of the marker device relative to the cameracan be determined from the size of the pattern in the image, theorientation of the pattern in the image and the distortion of thepattern in the image. This allows determining the relative position inup to three rotational dimensions and up to three translationaldimensions from a single two-dimensional image.

The position of a marker device can be ascertained, for example by amedical navigation system. If the marker device is attached to anobject, such as a bone or a medical instrument, the position of theobject can be determined from the position of the marker device and therelative position between the marker device and the object. Determiningthis relative position is also referred to as registering the markerdevice and the object. The marker device or the object can be tracked,which means that the position of the marker device or the object isascertained twice or more over time.

A navigation system for computer-assisted surgery preferably comprisesthe aforementioned computer for processing the data provided inaccordance with the computer implemented method as described in any oneof the embodiments described herein. The navigation system preferablycomprises a detection device for detecting the position of detectionpoints which represent the main points and auxiliary points, in order togenerate detection signals and to supply the generated detection signalsto the computer, such that the computer can determine the absolute mainpoint data and absolute auxiliary point data on the basis of thedetection signals received. A detection point is for example a point onthe surface of the anatomical structure which is detected, for exampleby a pointer. In this way, the absolute point data can be provided tothe computer. The navigation system also preferably comprises a userinterface for receiving the calculation results from the computer (forexample, the position of the main plane, the position of the auxiliaryplane and/or the position of the standard plane). The user interfaceprovides the received data to the user as information. Examples of auser interface include a display device such as a monitor, or aloudspeaker. The user interface can use any kind of indication signal(for example a visual signal, an audio signal and/or a vibrationsignal). One example of a display device is an augmented reality device(also referred to as augmented reality glasses) which can be used asso-called “goggles” for navigating. A specific example of such augmentedreality glasses is Google Glass (a trademark of Google, Inc.). Anaugmented reality device can be used both to input information into thecomputer of the navigation system by user interaction and to displayinformation outputted by the computer.

A navigation system, such as a surgical navigation system, is understoodto mean a system which can comprise: at least one marker device; atransmitter which emits electromagnetic waves and/or radiation and/orultrasound waves; a receiver which receives electromagnetic waves and/orradiation and/or ultrasound waves; and an electronic data processingdevice which is connected to the receiver and/or the transmitter,wherein the data processing device (for example, a computer) for examplecomprises a processor (CPU) and a working memory and advantageously anindicating device for issuing an indication signal (for example, avisual indicating device such as a monitor and/or an audio indicatingdevice such as a loudspeaker and/or a tactile indicating device such asa vibrator) and a permanent data memory, wherein the data processingdevice processes navigation data forwarded to it by the receiver and canadvantageously output guidance information to a user via the indicatingdevice. The navigation data can be stored in the permanent data memoryand for example compared with data stored in said memory beforehand.

DESCRIPTION OF THE FIGURES

In the following, the invention is described with reference to theappended figures which give background explanations and representspecific embodiments of the invention. The scope of the invention ishowever not limited to the specific features disclosed in the context ofthe figures, wherein

FIGS. 1a and 1b illustrate the two approaches to automatic imageregistration known from the state of the art;

FIG. 2 shows a basic flow of the method according to the first aspect;

FIGS. 3 to 8 illustrate perspective views of the system according to thefifth aspect;

FIGS. 9 to 13 illustrate perspective views of the registration frame;

FIGS. 14a to 16 illustrate perspective views of the tracking frameconnector;

FIG. 17 illustrates use of the system according to the fifth aspect forimplementing the method according to the first aspect; and

FIG. 18 is a block diagram illustrating the components of the systemaccording to the sixth aspect.

FIG. 1a illustrates the first prior art approach discussed above, andFIG. 1b discusses the second prior art approach discussed above.

FIG. 2 is a flow diagram illustrating the basic steps of the disclosedmethod in accordance with the first aspect, which in the illustrativeexample of FIG. 1 starts with a step S11 of acquiring the planning imagedata. In subsequent step S12, the construction data is acquired,followed by step S13 which encompasses determining the registrationbetween the anatomical body part in the planning image and the opticalmarkers.

FIGS. 3 to 8 illustrate the system according of the fifth aspect frommultiple perspectives. Throughout the figures, same reference signsdenote the same parts. The system 1 is suitable for conducting medicalnavigation and comprises a tracking frame 13 and a registration frame 4.In the example of FIGS. 3 to 8, two tracking frames 13 are shown asbeing attached or attachable to the registration frame 4, even thoughthe method according to the first aspect requires only one trackingframe 13 to be executed. The tracking frame 13 includes at least onetracking frame image marker 11 and four optical markers 3 arranged onthe arms of reference star embodying a tracking marker array 2. Theregistration frame 4 comprises a patient support unit attachment portion9 for attaching the registration frame 4 to a patient support unit (e.g.to a headrest). The patient support unit attachment portion 9 may takethe form of a throughhole formed perpendicular to a surface of a centralbase part 14 of the registration frame 4.

The tracking frame 13 is coupled to the registration frame 4 via atracking frame connector 6 which is illustrated in further detail inFIGS. 14 a to 16. The tracking frame connector 6 comprises anarticulated base part 18 having a throughhole 16 at its lower end forfeeding through a screw 7 for attaching the tracking frame connector 6to an attachment part 5 formed in the registration frame 4 for attachingthe tracking frame 13 to the registration frame 4. The attachment part 5and the throughhole 16 are each provided with a toothed circumferencecomprising interlocking teeth so that a stable positioning of thetracking frame 13 to the registration frame 4 is supported. The trackingframe image marker 11 at the lower end of the tracking frame 13 or thetracking frame connector 6, respectively, is enclosed in a housing(which in the embodiment shown in the figures may for example becircular) protruding from the side of the tracking frame 13 or thetracking frame connector 6, respectively, which, when attached to theregistration frame 4, faces the registration frame 4. At its upper end,the tracking frame connector 6 comprises three locks for interlockingwith the tracking marker array (for example, a suitably adapted basepart of the tracking marker array 2).

As may be seen from the bottom view of the system 1 illustrated in FIG.4, the registration frame 4 comprises a total of eleven registrationframe image markers 12 in the interior of the material forming theregistration frame 4 which are distributed along the side arms 8 of andthe base part 14 of the registration frame 4 in an unsymmetric manner.Furthermore, the registration frame 4 comprises fixing parts 15 formedas circular recesses in the side arms 8 into which the housing which atleast partly encloses the tracking frame image marker 11 of the trackingframe 13 or the tracking frame connector 6, respectively, is insertedwhen the screw 7 lead through throughhole 16 and the attachment part istightened. Thereby, the spatial relationship between the tracking frame13 and the registration frame 4 is fixed and stabilized, and therelative orientation between the tracking frame 13 and the registrationframe 4 is a predetermined orientation when the tracking frame 13 or thetracking frame connector 6, respectively, is attached with theregistration frame 4. The registration frame 4 is illustrated in moredetail in FIGS. 8 to 13, wherein notably FIG. 11 is a top view, FIG. 12is a side view, FIG. 13 is a perspective view from overhead showing thesystem 7 of FIG. 8 nut with the tracking frame 13 removed, and FIG. 9 isview from below, and FIG. 10 is another side view (end view) of theregistration frame from a direction perpendicular to the viewingdirection of FIG. 12. As can be seen from the figures, the registrationframe 4 comprises a total of four attachment parts 5 and each anassociated fixing part 15 (i.e. a total of four fixing parts 15) so thata tracking frame 13 or tracking frame connector 6, respectively, may beattached to the registration frame 4 at each one of the predeterminedpositions on the registration frame defined by the attachment parts 5 inassociation with the fixing parts 15.

FIGS. 14a to 16 show different perspectives of the tracking frameconnector 6. From those figures, it is clear that the housing of theimage marker 11 included in the tracking frame 13 or the tracking frameconnector 6, respectively, protrudes from the lower end of the base part18 of the tracking frame connector 6 in a direction facing towards theregistration frame 4 when the tracking frame 13 is attached to theregistration frame 4. The housing and the image marker 11 are formedsuch that the housing (and, for example, the image marker 11) can belocated in, i.e. fits into, the fixing parts 15.

FIG. 17 illustrates use of the system according to the fifth aspect forimplementing the method according to the first aspect. An anatomicalbody part 19 (in this case, the head) of the patient is placed on apatient support unit to which the system 1 is attached. FIG. 17illustrates use of an optional second tracking frame 13 (shown in dashedlines) in addition to a first tracking frame 13 (shown in solid lines).Each one of the two tracking frames comprises not only image marker 11but three image markers 11. This allows attaching the tracking frame 13to the registration frame 4 without having a predetermined orientationof the tracking frame 13 relative to the registration frame 4. Theorientation of the tracking frame 13 relative to the registration frame4 may be determined from the planning image because the geometry of thearrangement of image markers 11 is known and the imaged geometry can becompared to the known geometry in order to determine the orientation.

The method according to the first aspect allows for automaticregistration of an image data set (the planning image data) by detectingthe registration frame 4 in the image data set and using the trackingframe 13. The registration frame contains the image markers 12 that aredetectable in the image data set whereas the tracking frame 13 containsboth the image markers 11 that are detectable in the image data set andoptical markers 3 (navigation markers) that are visible to an optical,electromagnetic, or other tracking system. The tracking frame connector6 for connecting the tracking frame 13 to the registration frame 4includes one or more image markers 11 for detection in the image dataset. The tracking frame connector 6 and the tracking marker array 2could also be one part. The tracking frame connector 6 provides adistinctive interface for the tracking frame 13. The image marker(s) 11in the tracking frame connector 6 enable the position detection of thetracking frame 13 in the image data set. The number of position markersin the tracking frame connector 6 affects the degrees of freedom theinterface between registration frame 4 and tracking frame connector 6may provide.

The registration REG is the spatial relation of the optical markers 3 tothe planning image data. This spatial relation is defined by at leastthe following three components:

-   -   1. The known spatial relation, the tracking frame-transformation        M_(T), of the optical markers 3 and the image markers 11 in the        tracking frame.    -   2. The calculated spatial relation, the        tracking-registration-transformation M_(TR), of the image        markers 11 in the tracking frame 4 and the image markers 12 in        the registration frame 4.    -   3. The calculated spatial relation, the        frame-patient-transformation M_(R), of the image markers 12 in        the registration frame 4 and the image data.

M_(T) is given by the construction data of the tracking frame 4.

M_(TR) is calculated in the following way:

Image markers are detected by an algorithm executed on the planningimage data. For example, image markers for CT data must comprise amaterial that has a distinguishable Hounsfield value compared to itssurrounding volume, whereas image markers for MR data often containwater that contrasts to the surrounding air.

If the pixel value of an image marker (e.g. for CT the Houndsfieldvalue) is roughly known, the algorithm filters the image data by puttinga window of a certain size around this value and removes all imagecontents outside this window. Ideally only the markers remain in thisfiltered data set. If this pixel value is not known (as often for MR),the image data have to be searched by a moving window filter to find thecorrect pixel value.

Knowing the shape and size of an image marker, the algorithm thensearches for features in the image data that have that size and shape,removing all other features. This may be done by applying the well-knownconnected components approach.

In a last optimization step, the remaining features in the image datacan be analyzed with respect to their quality of fit: for example for aspherical marker the spherical mismatch can be calculated (i.e. how wellthe voxels of the markers fill a sphere of a known radius).

The centre of each image marker 11, 12 found in this way is thecoordinate of that marker in the image data resulting in a set ofdetected marker coordinates.

The set of marker coordinates now ideally contains both, the imagemarker(s) 11 of the tracking frame 13 and the image markers 12 of theregistration frame 4. Since the geometry of both the marker(s) 11 of thetracking frame 13 and the markers 12 of the registration frame 4 areknown, an optimization algorithm searches all marker coordinates in theimage data that have the best fit to the marker coordinates of thetracking frame, as well as to the marker coordinates of the registrationframe 4, respectively. This can be done by well-known least squaresoptimization algorithms.

This eventually results in the mapping of the coordinates of theregistration frame 4 to the image data set and the mapping of thecoordinates of the tracking frame 13 to the same image data set. Knowingboth mappings, the relation of the tracking frame 13 to the registrationframe 4 in the image coordinate system (i.e. the relation M_(TR)) can beeasily calculated by multiplication of the two mapping matrices. Therelation M_(R) is the mapping of the registration frame to the imagedata coordinate system.

The final image registration is now calculated in one step by chainingall three transformations determined above: M_(T)*M_(TR)*M_(R)

The number of image markers 12 in the registration frame 4 has to besufficient to find a unique mapping of the markers to the image dataset. The absolute minimum number of image markers 12 here is three.

The number of image markers 11 in the tracking frame 13 depends on thedegrees of freedom of the variability of the orientation of the trackingframe 13 with respect to the registration frame 4. If this degree offreedom is one, one image marker 11 is sufficient. The more degrees offreedom, the more image markers 11 are required.

By knowing the spatial relation between the tracking frame 13 and theregistration frame 4, the following advantages are achieved:

-   -   no additional tracking frame 13 is required and therefore no        further transformation step between tracking frames 13 is needed        that possibly decreases accuracy;    -   the tracking frame 13 can be mounted to different positions        allowing more freedom for the surgery setup, higher accuracy and        less visibility problems.

In general the hardware can be manufactured by milling, injectionmolding or rapid manufacturing technologies like selective lasersintering or likewise. The materials shall be suitable for therespective imaging technology (e.g. MRI, CT). For example, plastics areused which could be fiber-reinforced.

A system 20 according to the sixth aspect for navigating an anatomicalbody part 19 is schematically illustrated in FIG. 18. The system 20comprises:

-   -   at least one computer 21 configured to execute a program for        implementing the method according to the first aspect;    -   at least one electronic data storage device 22 storing at least        the planning image data and the construction data;    -   the system 1 according to the fifth aspect; and    -   a tracking device 23 for tracking the position of the optical        markers 3,    -   wherein the at least one computer 21 is operably coupled to        -   the at least one electronic data storage device 22 for            acquiring, from the at least one data storage device 22, at            least the planning image data and the construction data, and        -   to the tracking device 23 for acquiring, from the tracking            device 23, signals corresponding to information about the            positions of the optical markers 3.

1. A method for navigating an anatomical body part using a dataprocessing computer comprising a memory device storing code and aprocessor operable to execute the code stored in the memory device toperform the method for navigating comprising: acquiring planning imagedata, the planning image data depicting the anatomical body partsupported by a patient support device, and the planning image datadepicting at least three image markers provided in or on a registrationframe attached with the patient support device, wherein the planningimage data describes a frame-patient transformation (M_(R)) defining arelative position between the at least three image markers and theanatomical body part, wherein the planning image data further describesa tracking-registration transformation (M_(TR)) defining a relativeposition between the image markers provided in or on the registrationframe and an image marker provided in or on a tracking frame connectorconnected with the registration frame, wherein the tracking frameconnector is defined by a portion of a tracking frame, the trackingframe comprising a tracking marker array comprising at least threeoptical markers, wherein the tracking frame connector is connected withboth the tracking marker array and the registration frame, wherein thetracking frame is attached with the registration frame at apredetermined position on the registration frame, and wherein a locationof the predetermined position on the registration frame at which thetracking frame is attached is determined based on thetracking-registration transformation M_(TR), and wherein the trackingmarker array and the tracking frame connector are provided as separateconnected pieces; acquiring construction data, the construction datadescribing a predetermined tracking frame transformation (M_(T))defining a relative position between the at least three optical markersand the image marker provided in or on the tracking frame connector,wherein a relative position between the image markers provided in or onthe registration frame and the image marker provided in or on thetracking frame connector is determined based on the location of thepredetermined position on the registration frame at which the trackingframe is attached and the construction data; determining a registration(REG) of the anatomical body part as a relative position between theoptical markers and the depiction of the anatomical body part by theplanning image data, wherein determining the registration REG comprisesdetermining the registration REG based on the frame-patienttransformation M_(R) and by determining the relative position betweenthe image markers provided in or on the registration frame and theoptical markers based on the tracking-registration-transformation M_(TR)and the tracking frame-transformation M_(T).
 2. The method according toclaim 1, wherein the frame-patient transformation M_(R) is defined in aplanning reference system, the method further comprising: acquiringmarker navigation data, the marker navigation data describing a positionof the optical markers in a navigation reference system; andtransforming the position of the anatomical body part between a planningreference system in which positions in the planning image data aredefined and the navigation reference system using a reference systemtransformation.
 3. The method according to claim 2, comprisingtransforming the position of the anatomical body part from the planningreference system into the navigation reference system using thereference system transformation.
 4. The method according to claim 1,wherein he acquiring the planning image data depicting the at leastthree image markers provided in or on a registration frame attached withthe patient support device comprises acquiring the planning image datadepicting at least three image markers are arranged in or on theregistration frame in an un-symmetric pattern, for examplethree-dimensionally un-symmetric three-dimensional pattern.
 5. Themethod according to claim 1, further comprising determining the relativeposition between the image markers provided in or on the registrationframe and the at least three optical markers of the tracking markerarray of the tracking frame based on the tracking frame-transformationM_(T).
 6. The method according to claim 1, wherein the registrationframe is provided with at least two attachment parts for attaching withthe tracking frame, and wherein the tracking frame is attached with theregistration frame at the predetermined position on the registrationframe at a selected one of the at least two attachment parts.
 7. Themethod according to claim 1 wherein acquiring the planning image datacomprises: acquiring planning image data depicting at least part of thehead of an associated patent supported by a headrest of the patientsupport device.
 8. A non-transitory computer-readable medium includinginstructions stored thereon for supporting navigating an anatomical bodypart in data processing computer having a microprocessor and memory,which instructions, when executed cause data processing computer toperform steps comprising: acquiring planning image data, the planningimage data depicting the anatomical body part supported by a patientsupport device, and the planning image data depicting at least threeimage markers provided in or on a registration frame 4 attached with thepatient support device, wherein the planning image data describes aframe-patient transformation (M_(R)) defining a relative positionbetween the at least three image markers and the anatomical body part,wherein the planning image data further describes atracking-registration transformation (M_(TR)) defining a relativeposition between the image markers provided in or on the registrationframe and an image marker provided in or on a tracking frame connectorconnected with the registration frame, wherein the tracking frameconnector is defined by a portion of a tracking frame, the trackingframe comprising a tracking marker array comprising the at least threeoptical markers, wherein the tracking frame connector is connected withboth the tracking marker array and the registration frame, wherein thetracking frame is attached with the registration frame at apredetermined position on the registration frame, wherein a location ofthe predetermined position on the registration frame at which thetracking frame is attached is determined based on thetracking-registration transformation M_(TR), and wherein the trackingmarker array and the tracking frame connector are provided as separateconnected pieces; acquiring construction data, the construction datadescribing a predetermined tracking frame transformation (M_(T))defining a relative position between the at least three optical markersand the image marker provided in or on the tracking frame connector,wherein a relative position between the image markers provided in or onthe registration frame and the image marker provided in or on thetracking frame connector is determined based on the location of thepredetermined position on the registration frame at which the trackingframe is attached and the construction data; determining a registration(REG) of the anatomical body part as a relative position between theoptical markers and the depiction of the anatomical body part by theplanning image data, wherein determining the registration REG comprisesdetermining the registration REG based on the frame-patienttransformation M_(R) and by determining the relative position betweenthe image markers provided in or on the registration frame and theoptical markers based on the tracking-registration-transformation M_(TR)and the tracking frame-transformation M_(T).
 9. The computer-readablemedium according to claim 8, wherein the frame-patient transformationM_(R) is defined in a planning reference system, the method furthercomprising: acquiring marker navigation data, the marker navigation datadescribing a position of the optical markers in a navigation referencesystem; and transforming the position of the anatomical body partbetween a planning reference system in which positions in the planningimage data are defined and the navigation reference system using areference system transformation.
 10. The computer-readable mediumaccording to claim 9, comprising transforming the position of theanatomical body part from the planning reference system into thenavigation reference system using the reference system transformation.11. The computer-readable medium according to claim 8, wherein heacquiring the planning image data depicting the at least three imagemarkers provided in or on a registration frame attached with the patientsupport device comprises acquiring the planning image data depicting atleast three image markers are arranged in or on the registration framein an un-symmetric pattern, for example three-dimensionally un-symmetricthree-dimensional pattern.
 12. The computer-readable medium according toclaim 8, further comprising determining the relative position betweenthe image markers provided in or on the registration frame and the atleast three optical markers of the tracking marker array of the trackingframe based on the tracking frame-transformation M_(T).
 13. Thecomputer-readable medium according to claim 8, wherein the registrationframe is provided with at least two attachment parts for attaching withthe tracking frame, and wherein the tracking frame is attached with theregistration frame at the predetermined position on the registrationframe at a selected one of the at least two attachment parts.
 14. Thecomputer-readable medium according to claim 8, wherein acquiring theplanning image data comprises: acquiring planning image data depictingat least part of the head of an associated patent supported by aheadrest of the patient support device.
 15. A system for navigating anassociated anatomical body part, the system comprising: a computercomprising at least one processor, a memory, and a non-transitoryprogram storage medium storing a program thereon that, when executed bythe processor performs a method comprising: acquiring planning imagedata, the planning image data depicting the anatomical body partsupported by a patient support device, and the planning image datadepicting at least three image markers provided in or on a registrationframe attached with the patient support device, wherein the planningimage data describes a frame-patient transformation (M_(R)) defining arelative position between the at least three image markers and theanatomical body part, wherein the planning image data further describesa tracking-registration transformation (M_(TR)) defining a relativeposition between the image markers provided in or on the registrationframe and an image marker provided in or on a tracking frame connectorconnected with the registration frame, wherein the tracking frameconnector is defined by a portion of a tracking frame, the trackingframe comprising a tracking marker array comprising the at least threeoptical markers, wherein the tracking frame connector is connected withboth the tracking marker array and the registration frame, wherein thetracking frame is attached with the registration frame at apredetermined position on the registration frame, wherein a location ofthe predetermined position on the registration frame at which thetracking frame is attached is determined based on thetracking-registration transformation MTR, and wherein the trackingmarker array and the tracking frame connector are provided as separateconnected pieces; acquiring construction data, the construction datadescribing a predetermined tracking frame transformation (M_(T))defining a relative position between the at least three optical markersand the image marker provided in or on the tracking frame connector,wherein a relative position between the image markers provided in or onthe registration frame and the image marker provided in or on thetracking frame connector is determined based on the location of thepredetermined position on the registration frame at which the trackingframe is attached and the construction data; determining a registration(REG) of the anatomical body part as a relative position between theoptical markers and the depiction of the anatomical body part by theplanning image data, wherein determining the registration REG comprisesdetermining the registration REG based on the frame-patienttransformation M_(R) and by determining the relative position betweenthe image markers provided in or on the registration frame and theoptical markers based on the tracking-registration-transformation M_(TR)and the tracking frame-transformation M_(T;) at least one electronicdata storage device storing at least planning image data andconstruction data; a system for conducting medical navigation, thesystem comprising: a tracking frame comprising a tracking marker arraycomprising at least three optical markers; a registration frame,comprising: a patient support unit attachment part for attaching theregistration frame with a patient support unit; at least three imagemarkers arranged in or on the registration frame; and a plurality ofattachment parts for selectively attaching the tracking frame directlyor indirectly with the registration frame; and a tracking frameconnector comprising an image marker provided in or on the trackingframe connector, the tracking frame connector being operable toselectively connect the tracking frame with the registration frame,wherein the tracking marker array and the tracking frame connector areprovided as separate connected pieces; and a tracking device fortracking the position of the optical markers, wherein the computer isoperably coupled with the at least one electronic data storage devicefor acquiring, from the at least one data storage device, at least theplanning image data and the construction data, wherein the computer isoperably coupled with the tracking device for acquiring, from thetracking device, signals corresponding to information about thepositions of the optical markers.